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  1. travelRN555

    Primary care in urgent care

    This is just solely an urgent care system with an EHR designed specifically for urgent care. Most of the time the MAs don’t enter the proper history and there has been more than one occasision a provider has prescribed a medication that the patient is allergic to because the MA didn’t bother to put in the allergy list and simply clicked ‘no allergies’, despite the patient having written the information on their forms.
  2. travelRN555

    Primary care in urgent care

    Djmatte- I think you are absolutely right about the money..... we were also told we have to check in EVERYONE, even if we know we can’t treat them in the clinic and then bill them for a visit even though we are sending them to the ER- because ‘it’s the law’. I worked in the ER and am very familiar with EMTALA- but as far as I knew it only applied to emergency departments?? And what law says that if a patient is even greeted by a provider we must legally bill them for services? For example our policy is age 2 and up- but a stable 6 month old with a fever comes in- or a patient with an open fracture - things that you can immediately tell cannot be treated and safely sent along to the appropriate place- are to be checked in, wait to see the provider, and then told we don’t have the resources to treat them. Is this the same in your urgent care?
  3. travelRN555

    Primary care in urgent care

    I recently started what I thought was going to be my dream job- Working in an urgent care with another provider with me as the clinic is typically busy. The reality is I’m often alone and see 35-50 patients in a day with limited support staff. Door to discharge target time is 1 hour. Our medical director has recently made a point of training the new hires on a variety of topics, including ‘limited primary care’ to limit referrals Long story short: the expectation is that we are to diagnose/treat/follow-up/manage new diabetes, hypertension, and lipids in the urgent care. Including giving insulin in the clinic and initiating regimens, dosing clonidine and starting them on one ore more antihypertensive. And ordering all the initial diagnostics. My concerns are that the charting system is not set up for primary care documentation, we don’t have consistent schedules, and patients cannot schedule appointments. Labs are reviewed and dealt with by whomever is on the day that they result in the system and providers often work in multiple locations in the network. I’m new to urgent care, so I’m not sure how other clinics work. Is this consistent with where others work- providing some primary care services-but not others, managing another provider’s primary care labs, etc?
  4. travelRN555

    Just got an ED RN position, Advice needed PLS!

    Learn to go with the flow, adapt quickly, and constantly reprioritize. In the ER there is no refusing to take a patient/report from the new EMS that just arrived, and it's not uncommon to get 2-3 new patients land in your rooms at the same time. The ER also has lots of time targets as far as door to EKG, antibiotic administration, cath lab, TPA, etc times. You need to be able to drop whatever non-emergent task you are doing and go settle/stabilize a new arrival, then go back to finish up what you were doing.
  5. travelRN555

    Walden University FNP

    Yes, but it took forever. I got hired at a brand new urgent care. I have yet to start though because they are still finishing construction.
  6. travelRN555

    Good school that offers FNP programs online

    Hospitals are beginning to crack down on the hiring of online program graduates. Hospitals in my area won't even bother looking at your application if they see that you went to an online only school. I went to a 100% online program and while I passed the boards without any issue, if I had a chance to redo it I would have done a little more research and selected a different school.
  7. travelRN555

    no contract job offer

    I'm just worried that if I'm on salary they can make me work a billion hours a week (the clinic will be open 24/7) or change up their medicial benefits Bc initially they said they wouldn't offer any, but then the medical director said they would have catastrophic and prescription coverage. I'm so used to travel contracts that spell everything out.
  8. travelRN555

    no contract job offer

    OK... So I've been on the struggle bus trying to get a new grad NP job. I had an offer back in February and turned it down because of bad contract terms. A couple weeks ago, I was offered another job and accepted it at a brand new facility. They sent me an offer letter with the basic information about salary and days off, etc. There are no mention of scheduling, or the benefits they discussed (medical, CME, etc) in the interview, or even which department I would be in. The operations manager emailed me just to touch base and I asked her if there would be a formal contract and when they thought the facility would be open (they are still finishing construction). She said that there is no formal contract. I'm a little surprised, and feel like I could get royally screwed, although if there is no contract they are not protected either. Has anyone else taken a job without a contract??
  9. travelRN555

    guaranteed hours?

    I work in ER and we never get called off and it's extremely rare that we are flexed when it's a slow day because you never know what will walk through the doors. My agency guarantees my pay, but not my hours and there are stipulations. For example, there was one week that I went home on my contracted days off, but the hospital didn't give me shifts on the days I was available, so I was short hours that week - and I was responsible for missed hour charges because I was not available when they had needs. The agency also requires that the manager or charge nurse sign a form saying that it was the facilities decision for you to miss hours and you didn't elect to be flexed. Then you will get paid for your contracted hours, without having worked a full set. My agency will also reverse any missed hour charges if you make up the extra hours in another week (and you get overtime pay too). I think more agencies are including guaranteed hours into the contract with the hospitals, because the few times I have asked to go home on a slow day when I was the 3rd float nurse, they tell me they can't let me go because they have to pay me anyway.
  10. travelRN555

    Travel nurse insurance revoked

    My agency offers day 1 medical and you can take up to 2 weeks off between assignments without losing coverage. You can stretch it to 3 week with creative scheduling, but I've only ever had one assignment start on a Friday. If you take approved time off during an assignment they won't pay your stipend because at the end of the day your stipend is tied to your hours worked. I've been traveling for over 5 years and have worked all but 2 assignments with my current agency. What I have found is that at the end of the day the hospitals all pay the same rates and companies will divvy up that money in various ways, so while some nurses may be making more per week, they might have less benefits such medical coverage, CEs and certifications paid for. They may also be risking being flagged by the IRS. Your friends who have had stipends paid for during their time off may have negotiated a lower rate which would have covered their time off, or worked OT the other weeks to make up their total contracted hours (I did that when I took 2 weeks off during a contract)....or they have been with their agencies forever and are offered a few added perks for their loyalty.
  11. travelRN555

    Walden University FNP

    I graduated from their program last year. There is a lot of 'busy work' with papers and discussions. If you want to get the most out of the program I would not advise doubling up on courses as you are responsible for teaching yourself all of the material. I would suggest that you do a little research to see if facilities in your area are willing to take graduates from online only programs. Where I live one of the largest healthcare systems won't even look at your application if you attended an online proprietary school. I would also suggest looking through some of the other threads on here regarding current NP education. I don't want to be negative, but I think that many of the opinions about low standards of many of the online programs are legitimate. I wish I had done more research before I selected my program.
  12. travelRN555

    New nurse practitioner

    You just need to keep at it... I graduated last August and just finally got a job this week. I think I applied to 100-150 jobs and only had 1 other legitimate offer that turned out to be super sketch when it came to contract review - and that was only after 6 months of searching. Hospice is very specific; you may need to broaden the type of specialty you are willing to work in, or move to another area that has a hospice need. Good luck.
  13. travelRN555

    FNP Board Prep - pretest scores

    I personally would advise more than just skimming the Liek book. I passed the boards last September and feel that her content and questions were the most related to the exam. Good luck!
  14. travelRN555

    Nursing Certs as APRN

    Does anyone maintain their nursing certifications as an NP? For example, I have my CEN, CPEN, TNCC, ENPC which are all nursing specific... should I bother to renew these now that I'm an NP?
  15. travelRN555

    recruiter contract/finder's fees

    I spoke to a company who wants me to sign a basic contract so that they can "begin looking for placements and disclose their opportunities". The contract seems rather benign except for a clause that says that they get 25% of the provider's salary if the provider takes a job with the facility within 2 years of the locum contract and that if the facility won't pay the provider has to. Has anyone signed a contract with a recruiter BEFORE being offered a job? I know that agencies tend to have finder's fees, but has anyone had to pay for themselves??